Haunted by the ghosts of war

CFP PETAWAWA — Corporal Shaun Arntsen and his buddy Richard Green were playing cards near Kandahar in April 2002, when they were forced to abandon their game and head to the anti-armour range for night training. Both were members of Third Battalion of Princess Patricia’s Canadian Light Infantry. Before dawn broke the next day, Private Green and three other members of the Princess Pats — Sergeant Marc Leger, Cpl. Ainsworth Dyer and Pte. Nathan Lloyd Smith — were dead, killed in the Tarnak Farm friendly fire incident by an American F-16 fighter jet that dropped a laser-guided bomb on the Canadians by mistake.

Cpl. Arntsen found the body of one of his friends before heading back to base. “My last memory of Rick Green is putting our cards inside a box because we didn’t finish the game. That’s what I came back to — an unfinished cribbage game. I talked to Marc Leger six minutes before he died. It was a pretty tough day,” he said in an interview.

Shaun Arntsen escaped physical harm but he was injured nonetheless. The consequences for the then-married father of one daughter and two stepchildren have become all too familiar — post-traumatic stress disorder that resulted in the end of his military career, court-martial, marital break-up and drink and drug dependency.

With the end of the combat mission in Afghanistan, the Department of National Defence anticipates a gathering storm of PTSD and operational stress injury (OSI) victims, with some estimates suggesting one in four returning veterans may develop mental health problems. One parliamentary committee heard that, of 27,000 deployed CF personnel, 1,200 may be affected by post-traumatic stress disorder and a further 3,600 could face other mental health concerns.

Cpl. Arntsen said when he got back to base in Edmonton he found he couldn’t sleep, became obsessive about working out in the gym and developed agoraphobia. “My ex-wife went through hell. I was short-tempered and became abusive and physically violent. My daughter would look at me and wonder why going to the water park or the mall was such a big deal,” he said. A doctor diagnosed him with PTSD and he started drinking and using cocaine to dull the pain. “I don’t remember my last year in the military,” he said.

In 2004, he was court-martialled for being absent without leave and spent 17 days in pre-trial custody. On the day of the trial, the first question the judge asked was why Cpl. Arnsten was in his court, when a doctor had already said he shouldn’t even have been at work. He was eventually given a medical release, although he says the military fought to give him an administrative release, which he likened to “a dishonourable discharge.” The future looked bleak for the then-30-year-old, still haunted by his “old ghosts.”

Other veterans have found themselves unable to come to terms with their experiences and turned to suicide. In late June, Corporal James McMullin from Glace Bay, Cape Breton, was found dead at CFB Gagetown. His father, Darrell, told the Post’s Joe O’Connor that he was a different person when he came home from Afghanistan. “I spoke to three other soldiers at his memorial that had been caught in their garages with a rope over the rafters,” he said.

Jim Lowther, a veteran of tours in Bosnia and Afghanistan, experienced an operation stress injury five years after being in a combat situation. “It’s not just the combat, it’s the death and smell and the bodies and being shot at; it’s picking up your buddy’s leg, seeing dead kids and genocide; it’s wondering why they’re lining people up and shooting them. Eventually, it will come out,” he said.

The sheer number of Canadian troops who have been to Afghanistan helps explain the anticipated wave of PTSD and OSI cases. The Department of Veterans Affairs notes it has seen OSI cases rise to 13,000 men and women from 2,000 a decade ago. National Defence admits it has no idea how many cases it has treated in the 10 years and it has been criticized by the Canadian Forces Ombudsman for having no database by which to gauge the extent of the problem.

Stung by criticism in a 2009 report by the Ombudsman that the government was showing “lukewarm leadership and commitment at the national level” toward PTSD, both National Defence and Veterans Affairs have been gearing up with new clinics, peer support groups and personnel centres.

Veterans Affairs now has 10 OSI clinics, DND has five, in addition to a network of 24 Integrated Personnel Support Centres, one-stop shops for ill and injured servicemen and women. There is also a peer-support program — the Operational Stress Injury Social Support Program (OSISS) — that National Defence claims has helped 5,500 CF members and veterans since 2001.

Colonel Simon Hetherington, commander of 2 Canadian Mechanized Brigade, based at CFB Petawawa, 170 km west of Ottawa, said experience from previous Afghan tours suggests that the reaction to combat-induced stress is delayed. “We’ve got some work ahead of us. We’re not kidding ourselves, there are going to be some very difficult times ahead,” he said. A task-force of almost 2,000 troops has recently returned to base.

Major Janice Magar, a military psychiatrist at the recently opened Operational Trauma and Stress Support Centre at Petawawa, said demand has been steady, in part because soldiers are more open and willing to be seen. “I joined the military in the early 1990s and there is a huge difference in terms of the stigma attached to OSI. Everyone has been there [to Afghanistan] and knows what to expect. We now have better treatments and better facilities.”

She said around 6% of cases are clinically diagnosed as post-traumatic stress disorder, a very precisely defined anxiety disorder with specific symptoms like nightmares, flashbacks, irritability and avoidance of people and places who remind the patient of their experience.

One criticism is that, while DND boasts it has 350 mental health workers, only a very small proportion are psychiatrists and clinical psychologists. At Petawawa, of 14 staff, four are psychiatrists and three psychologists. “It’s a bit of a work in progress,” Maj. Magar admitted. But she defended a military system some critics have accused of being slow and poorly resourced.

“Sometimes we do encounter military members complaining about wait times or access to services. I just wish they could have the opportunity to see the civilian world for a little while, where you don’t get your medication or therapy paid for and you wait six months to a year to see a psychiatrist. It’s quite a different world out there,” she said.

For current members of the Canadian Forces, then, a safety net seems to have been put in place, even if some tragic cases slip through — Cpl. McMullin, for example, was seeing military and civilian counsellors. The system might not be there for all of the people, all of the time. Military budget cuts have already led to whispers that more and more CF members off work for extended periods with operational stress injuries will find themselves released.

But, as Maj. Magar pointed out, CF soldiers have access to better and more immediate services than others whose lives have also been turned upside down by Afghanistan and other Canadian military engagements — namely, family members, veterans and civilians who have served overseas.

Bases such as Petawawa do provide family members with some initial services — for example, couples counselling is covered — and they have access to support programs like military family resource centres. But spouses and children are not eligible for ongoing treatment — a situation that angers critics of the status quo like Senator Roméo Dallaire, who believes the Canadian Forces and Veterans Affairs should take family members under their wing.

Pierre Daigle, the Ombudsman for National Defence, said the Canadian Forces has made progress since his office’s critical 2009 report — for example, Chief of Defence Staff Walter Natynczyk himself launched Mental Health Awareness Week — but “there’s still a lot to be done,” particularly when it comes to caring for military families. “When I go around the country, I tell families they are an entity — you can’t separate the military spouse from the member,” he said.

Another group that appears vulnerable to slipping through the safety net are those who have developed problems after leaving the Forces, which often means they have no military pension.

Jim Lowther founded the Veterans Emergency Transition Services outreach group after running into a veteran he served with while volunteering at a soup kitchen in Halifax. “He said he was homeless. I couldn’t believe it. Then he picked out three other homeless veterans just sitting there,” he said.

The problem is not limited to Halifax, one outreach project in Vancouver’s Downtown Eastside found 33 homeless veterans, most in their mid-30s.

Mr. Lowther is very critical of the OSI clinics and personnel support centres set up by National Defence and Veterans Affairs. “We’re downtown on patrol, working with the Salvation Army. What are they doing? Nothing. It’s just smoke and mirrors. It’s not working at all. They’re all military officers put in cozy positions and they don’t care. If they did, we wouldn’t need to be around.”

He said he has seen two recent cases where suicidal veterans were turned away by emergency room psychiatrists in Halifax. “The problem right across the country is going to get massive. When these guys call the suicide hotline, it sends them back to the ER. We have a lot of veterans on the streets and no place to take them.”

Veterans Affairs claims to have launched a number of pilot projects aimed at helping homeless vets but the office of new minister, Steven Blaney, did not make him available to discuss the issue.

Canadian Forces Ombudsman Pierre Daigle said there needs to be rationalization and reform of the various clinics and support centres designed to help service personnel. “They are all trying to help but I sense the coordination is not there,” he said.

A further group whose mental health needs are ignored by the existing system are the civilians who have served overseas with the Canadian International Development Agency and Foreign Affairs. Afghanistan is unique in recent engagements in the strong civilian contingent that served alongside the military as part of Canada’s 3D strategy — defence, diplomacy and development.

According to Ron Cochrane, executive director of the Professional Association of Foreign Service Officers, there has been little recognition that CIDA and Foreign Affairs workers were even in a war, despite the death of diplomat Glyn Berry and the injuries suffered by Bushra Saeed, a diplomatic officer who lost a leg in the roadside bombing that killed journalist Michelle Lang and four soldiers. “She was well-treated in Afghanistan and in Germany by the military, but in Canada she was transferred from being treated like a female soldier on to Workers’ Compensation, as if she’d been in a traffic accident. It’s ridiculous and a double standard,” he said.

The provision for mental health services is even more lacking. When it comes to operational stress injuries, CIDA and Foreign Affairs seem roughly where the military was a decade ago. Civilian Afghan vets have to pay for their own PTSD therapy and there are concerns that it will take a suicide before the system is reformed.

Perhaps the only good news in this disturbing saga is that, as with other injuries, recovery is possible. Major Magar said that statistically, one third of patients make a full recovery and the vast majority show significant improvement with therapy. “This is not a career-ending diagnosis,” she said.

Shaun Arntsen is living proof that the road to recovery, while long and winding, is navigable. In 2006, he moved to Canmore, Alta., and began to work as a ski instructor. He still feels agoraphobic but said he’s rid himself of many of his ghosts, largely by talking about his experiences with other veterans. He currently works as a ski racing coach and professional driver. “When I first got out, I couldn’t work, I couldn’t get up in the morning. I felt like I’d been shunned, labelled a bad soldier and I fell into depression. But now I’m highly motivated and I’ve got my work ethic going. I’m back to who I was before I went overseas in ’02.”